Organization
RAISE THE BOTTOM TRAINING & COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COURTNEY FERRARESE (BILLER)
(208) 433-0400
Entity
Organization
Contact information
Practice address
9196 W BARNES DR, BOISE, ID 83709-1552
(208) 433-0400
(208) 433-5271
Mailing address
9196 W BARNES DR, BOISE, ID 83709-1552
(208) 433-0400
(208) 433-5271
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CS5613
ID
101YA0400X
Addiction (Substance Use Disorder) Counselor
LMSW29959
ID
101YA0400X
Addiction (Substance Use Disorder) Counselor
MSW07060
ID
163W00000X
Registered Nurse
N21523
ID
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
N40356
ID
183500000X
Pharmacist
CS5613
ID
207QA0401X
Addiction Medicine (Family Medicine) Physician
M6153
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2387NTC
NARCOTIC TREATMENT CENTER
ID
01
—
ID-10008-M
OPIOID TREATMENT PROGRAM CERTIFICATION
ID
Enumeration date
01/19/2011
Last updated
12/13/2019
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